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Comparative Study between General Anesthesia versus General Anesthesia Combined with thoracic epidural analgesia on Cytokine Response in Laparoscopic Cholecystectomy Patients

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Open Journal of Anesthesiology 2020年第6期10卷 247-262页

作者： Amir Abouzkry Elsayed Nagwa Mohammed Gamal EI-deen Gamal Hendawy Rezk Shams Ahmed Elsaied Abd-elrahman Aly Wafaa Salah Mohammed Department of Anesthesia and Intensive Care Faculty of Medicine Kafrelsheikh University Kafrelsheikh Egypt Department of Anesthesia and Intensive Care Faculty of Medicine Aswan University Aswan Egypt Department of Anesthesia and Intensive Care Faculty of Medicine Sohag University Sohag Egypt Department of Clinical Pathology Faculty of Medicine Aswan University Aswan Egypt

Background and Objectives: The main benefits of laparoscopic surgery in comparison to open surgery involve the rapid discharge from recovery room, decreased postoperative hospital stays, reduced postoperative discomfort, easier getting back to work and faster return to ordinary daily life as well as cosmetic surgical wounds. The anesthesia type has an essential role in attenuation of the surgical stress and achievement of these advantages. We aimed to determine the outcome of giving general anesthesia in conjunction with thoracic epidural analgesia (TEA) compared to general anesthesia alone on stress response to surgery and anesthesia by investigating cytokine reaction (interleukin 6 and 8 levels), hemodynamic changes (BP, HR, RR, SPO2), and Visual Analogue Scale (VAS) scores postoperatively in patients subjected for laparoscopic cholecystectomy. Methods: This study included 40 patients aged 20 - 60 years old with American Society of Anesthesiologists physical status (ASA) I and II. They were planned for laparoscopic cholecystectomy at Aswan University Hospital from April 2017 to March 2018. They were randomly allocated into two groups. Group A (n. 20) received general anesthesia only and Group B (n. 20) received general anesthesia in conjunction with thoracic epidural analgesia using fentanyl and bupivacaine in the epidural catheter. Chi-square was applied to differentiate categorical variables, whereas comparison between continuous variables was done by using t-test. Two-tailed p ficant. Results: As regards IL-6 and IL-8 post-operative there is significant difference (p nd and 4th h

关键词： General Anesthesia thoracic epidural analgesia Cytokine Laparoscopic Cholecystectomy

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A Comparative Study on Safety and Efficacy of Caudal, thoracic epidural and Intra Venous analgesia in Paediatric Cardiac Surgery: A Double Blind Randomised Trial

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World Journal of Cardiovascular Surgery 2020年第7期10卷 101-114页

作者： Mahesh Vakamudi Rajesh Kumar V. Kodali Ranjith B. Karthekeyan Periyasamy Thangavel Kamalakannan G. Sambandham Department of Anaesthesiology Sri Ramachandra Institute of Higher Education and Research (SRIHER) Chennai India Department of Cardiac Anaesthesiology Sri Ramachandra Institute of Higher Education and Research (SRIHER) Chennai India HOD Department of Cardiac Surgery Sri Ramachandra Institute of Higher Education and Research (SRIHER) Chennai India

Introduction:Regional anaesthesia combined with general anaesthesia reduces stress response to surgery, duration of ventilation, intensive care unit (ICU) stay and promotes early recovery. Studies on thoracic epidural, caudal analgesia along with general anaesthesia (GA) in paediatric cardiac surgery are limited hence we aimed to compare efficacy and safety of caudal, thoracic epidural and intravenous analgesia in paediatric cardiac surgery. Methodology: This study was conducted in the Department of Anaesthesiology in a tertiary care teaching hospital in southern India from February 2019 to December 2019. 90 children were randomised into group A, group B, group C. Children in group A received caudal analgesia along with GA. Group B children received thoracic epidural along with GA. Group C patients received intravenous analgesia along with GA. Rescue analgesia 1 mcg/kg fentanyl given in all 3 groups if pain score is more than 4. Primary outcome assessed was post-op pain scores. Secondary outcome assessed was duration of ventilation, duration of intensive care unit stay. Results: All patients were comparable in terms of age, sex, weight, mean RACHS score, baseline heart

关键词： Caudal analgesia thoracic epidural analgesia Pain Scores Paediatric Cardiac Surgery

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